Clinical workflows, meaning a chain of events and process steps from a first contact of a patient until his release out of a care program, is a complex cooperation of doctors, clinical staff, diagnostic questions, experimentations done by different departments, modalities, clinical data and conclusions. Such a clinical workflow is shown at 10 with steps 10 A-G (See FIG. 1). Due to a fast medical evolution of the last few years, these workflows have been expanded and adapted to new methods, techniques, systems and modalities without paying attention to integrating these changes into one aligned workflow.
Today, clinical workflows comprise a huge amount of different data, information, interfaces, options and parameters which have to be attended or entered by the doctors and clinical staff (See rules 12A-12F, information exchange 13A-13G, and Information Technology (IT) information 11A-11F in FIG. 1). Some of the same data has to be entered several times into different systems and modalities. For example, Cathlabs have been examined where key patient data (record number, name, age and weight) has to be entered manually in four different systems during one medical examination. Each of these manual data entries and unstructured presentations of information can be an additional source of error which causes additional costs and possibly dangerous complications.
During the last few years pressure to measure and optimize clinical workflows has increased enormously. Hospitals have to prove their quality and therefore have to provide a lot of additional data like timestamps, duration, and cost of process steps. This causes additional demands in an isolated fashion to the clinical staff 14 and the IT systems 11 and again increases the amount of data to deal with.
As to most parts of this problem doctors and clinical staff 14 have been left alone.
One attempt to decrease complications and entry of wrong data is a well organized and documented workflow. This is done most of the time by paper checklists such as in emergency departments.
For some other clinical departments there are special IT systems developed like Radiology Information Systems 11B (RIS) which solve some departmental lack of integration, but still require a lot of manual data entries.
There are a few modern IT systems such as SOARIAN 11E which now supports a main clinical workflow and can structure information depending on the user and situation. These systems can guide the overall workflow on a general level by a “workflow engine,” but do not support the departmental processes, which are the most critical ones. The different prior art IT systems are shown at 11 in FIG. 1: Hospital Information System 11A (HIS); Radiology Information System 11B (RIS); Cardiac Information System 11C (CIS); Picture Archiving System 11D (PACS) (which is, for example, images where results of modalities are stored); Specialized Information System 11 (SOARIAN) of Siemens AG, Munich, Germany (a workflow based system); and other IT systems 11F.
In summary, the prior art systems can either support single process steps or very general high level workflow only and are dependent on manual data entries. Without these entries, or with wrong entries, these systems are blind or cause problems and complications.